PERSONAL HEALTH; Keeping Those Bed Bugs From Biting

By JANE E. BRODY

Published: April 14, 2009

Throughout my early childhood I was tucked into bed with a gentle admonition: ''Good night, sleep tight. Don't let the bed bugs bite.'' Not that my parents or I had ever seen a bed bug or known anyone bitten by one.

But these days this old saying has resonance for many more people than in years past, including those who sleep in expensive homes and four-star hotels. Last month, a family living in a $3 million private house in Brooklyn discarded rooms' worth of furniture, the cushions carefully slashed and notes attached saying the pieces had bed bugs and were not safe to take.

Had this been the case 40-odd years ago when I became a New York homeowner, I might have had a hard time furnishing my rooms; most were decorated with foundlings, including cushioned chairs. In those days, street scavengers like me had little reason to worry about bed bugs.

But the bed bug problem has become so widespread in 21st- century America that The Journal of the American Medical Association published a clinical review in April, ''Bed Bugs and Clinical Consequences of Their Bites,'' by Jerome Goddard, a medical entomologist at Mississippi State University, and Dr. Richard deShazo, an allergist at the University of Mississippi Medical Center.

A Growing Problem

Although this blood-sucking parasite has been around for thousands of years, it was mainly associated with impoverished dwellings and fleabag hotels. Now, as the authors pointed out, ''international travel, immigration, changes in pest control practices, and insecticide resistance'' have ganged up to create ''a resurgence in developed countries,'' including the United States.

''Bed bug infestations have been reported increasingly in homes, apartments, hotel rooms, hospitals and dormitories in the United States since 1980,'' they wrote. Reported infestations in San Francisco doubled from 2004 to 2006; telephone complaints in Toronto rose 100 percent in six months during 2002; and the number of bed bug samples sent to authorities in Australia was 400 percent higher from 2001 to 2004, compared with the previous three years.

The critters can move easily from apartment to apartment through cracks in walls and floors. In the last fiscal year in New York City, a densely populated international destination with many people living in multifamily dwellings, bed bug complaints to the city's Department of Housing Preservation and Development rose to 8,840, nearly 2,000 more than in the previous fiscal year. And chances are, most residents of infested households, especially those in single-family dwellings, co-ops and condominiums, never complained to this agency.

There is some good news about bed bugs. The journal authors reported that although the insects have been blamed for transmitting more than 40 human diseases, ''there is little evidence that such transmission has ever occurred.''

The bad news is that even if bed bugs don't spread hepatitis or AIDS, they can engender feelings of shame and disgust, and they are difficult and often costly to eliminate.

Know the Enemy

Adult bed bugs are easy to see, but only if you look at the right time -- during the night on or near a human target. They do most of their feeding around 4 a.m.

The insects resemble ticks. Before a blood meal they are about three-eighths of an inch long, reddish brown, with a long nose tucked under a pyramid-shaped head and chest. After feeding, they may grow to more than half an inch. But you are more likely to see their remains in the morning: tiny black specks of excrement or perhaps a blood stain on the sheet if the sleeper happened to land on a well-fed bug.

During the day, bed bugs remain in the dark, hidden in mattress cords, cracks and crevices of box springs or seams of upholstered furniture, in the backs of headboards or joints of wooden bed frames, under loosened wallpaper, or even behind picture frames over a bed -- but almost always near where people spend the night.

Most people who are bitten by bed bugs do not react. Of the 30 percent or so who do, many mistake the small, pink, itchy bumps for mosquito bites, although people may become more suspicious and more sensitive with repeated bites.

People who are highly sensitive react with intense itching that prompts scratching and can lead to infections. One Brooklyn family did not know they were sharing quarters with bed bugs until a sensitive relative visited and woke in the morning with very itchy bites.

Still others may experience more extreme reactions, including asthma, generalized hives, and even a life-threatening allergy (anaphylaxis) that requires emergency treatment with epinephrine.

But most bed bug lesions can be treated with an anti-itch product like calamine lotion or a topical or oral corticosteroid and antihistamine. If bites become infected, a topical or oral antibiotic may be needed.

Prevention and Elimination

There is no effective repellent against bed bugs, so avoidance is the best protection. Resist the temptation to pick up discarded mattresses, sofas, cushioned chairs and similar furnishings that could harbor the bugs. If you can't pass up clothes left out for the taking, carry them away in a plastic bag and then either wash them as soon as possible in very hot water, place them in a hot dryer or have them dry cleaned.

The journal authors advise that ''items purchased at garage sales and resale shops, especially mattresses, box springs and bedding, be carefully inspected for bed bugs before they are brought into homes.''

It also helps to rid the house of clutter that can provide hiding places for the bugs. When traveling, check the bed for evidence of bugs before you get in. And when you return home, check your luggage for bugs that may have come along.

Home remedies -- usually ineffective -- are legion. One family tried standing the legs of their beds in dishes of mineral oil, which stained the floor but did not deter the bugs. The family ended up hiring a professional exterminator, which is often a more cost-effective strategy than do-it-yourself methods. After repeated treatments to the family's apartment and the neighbors', the exterminator now does routine maintenance.

Pesticide sprays are not recommended for use on bedding. More effective, though no bargain, is to encase the mattress and box spring in covers like those used against dust mite allergy. (They can be found for around $50 for a twin bed.)

Other remedies include high-suction vacuuming or heat or steam treatments of infested furniture, also best done by licensed professionals. If space and time are available, furniture suspected to harbor bed bugs can be placed in the sun for several days or out in the winter cold for about two weeks. The bugs can survive indoors for a long time without feeding, but when they are exposed to temperature extremes outside and have no food source, they die off or disappear.